Animals ; Apoptosis ; Endotoxins/toxicity* ; Heart/drug effects* ; MAP Kinase Signaling System ; Myocardium/pathology* ; Rats ; Rats, Wistar ; Receptors, Calcium-Sensing/metabolism*

Objective:To verify the accuracy and feasibility of radioactive 125I seed implantation assisted by an optical navigation system and a 3D-printing non-coplanar template in the treatment of recurrent head and neck cancers. Methods:A total of 12 patients with recurrent head and neck cancer treated with radioactive 125I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template were enrolled from Dec 2018 to Dec 2019.The pre-plan and post-implant implantation needle number and implanted seed number were recorded.Meanwhile, their dosimetric parameters were compared, including D90, minimum peripheral dose (MPD), V100, V150, V200, conformity index (CI), external index (EI), and the homogeneity index (HI) of the target volume. Results:The median lesion volume was 31.5 cm 3, the median number of seeds was 61.5, and the median prescription dose was 130 Gy.The means of the pre-plan D90, MPD, V100, V150 and V200 were 134.2, 64.6, 93.3, 75.3 and 39.3 Gy, respectively, while those of post-implant D90, MPD, V100, V150, and V200 were 146.7, 68.94, 97.47, 80.40 and 48.30 Gy, respectively, with no statistically significant difference ( P>0.05). Meanwhile, there was no statistically significant difference between the pre-plan and post-implantation needle number, implanted seed number, CI, HI, and EI ( P>0.05). In terms of postoperative dose quality assessment, eight cases were rated excellent (66.6%) and four cases were rated good (33.3%). Conclusions:Radioactive 125I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template can be accurately performed in the treatment of recurrent head and neck cancer, with good consistency between pre-plan and post-implant dosimetric parameters and thus of prospective potential in clinical application.

Objective:To compare preoperative planning parameters between non-coplanar and coplanar template-assisted radioactive seed implantation in the treatment of pancreatic cancers, in order to guide clinical application.Methods:Patients with pancreatic cancers who received external irradiation in the Peking University Third Hospital from Jan 2017 to May 2019 were selected.Their image information was imported into the brachytherapy planning system, and the non-coplanar plan and coplanar plan were designed individually.Each patient′s prescription dose was set to 110 Gy, and the activity of the radioactive seeds were 0.4 mCi(1 Ci=3.7×10 10Bq), respectively.For the two plans, the dose distribution was optimized and dosimetric parameters were compared, including the implantation needle number, the implanted seed number, the minimum prescription doses delivered to 90% and 100% of the target volume ( D90 and D100), mean percentages of volume receiving 100%, 150% and 200% of the prescription doses ( V100, V150 and V200), conformity index (CI), external index (EI), and homogeneity index (HI) of the target volume, as well as the doses of 2 cm 3 and 5 cm 3 ( D2 cm 3 and D5 cm 3) of the surrounding normal organs such as the small intestines, colon, duodenum, stomach, and spinal cord. Results:The implantation needle number in the coplanar plan was slightly higher than that in the non-coplanar plan, namely 18.63 vs. 16.45 ( t=-3.239, P <0.05). The implanted seed number was equivalent, namely 90.2 vs. 91.01, with no statistical difference ( P>0.05). There was no significant difference between D90, D100, V100, V150, V200, CI, EI, and HI in the target area of the two plans ( P>0.05). Meanwhile, there was no obvious difference in D2 cm 3 and D5 cm 3 of normal organs including the small intestines, colon, duodenum, stomach, and spinal cord ( P>0.05). Conclusions:With both the coplanar plan and the non-coplanar plan, the prescription doses can be achieved and meanwhile, there are very small differences in the doses of normal organs.Given that 3D-printing non-coplanar and coplanar templates have their own characteristics, it is necessary to choose them according to specific situations.

Objective:To explore the accuracy of CT-guided 125I seed implantation assisted by a navigation system and 3D-printing template in the treatment of recurrent malignant pelvic tumors by comparing pre-plan and intraoperative physical dosimetric parameters. Methods:This study involved 15 patients with recurrent malignant pelvic tumors who received CT-guided radioactive 125I seed implantation assisted by a navigation system and 3D-printing template in the Peking University Third Hospital from Dec 2018 to Feb 2020.Seven of the patients had cervical cancers, seven had rectal cancers, and one had prostate cancer.The median age was 55 years (34-84 years old). The prescription dose was 100-150 Gy.The pre-plan and post-implant data were compared, including the number of implanted seeds, implantation needle number, and some dosimetric parameters such as the minimum prescription doses delivered to 90% and 100% of target volume( D90, D100), mean percentages of volume receiving 100%, 150%, and 200% of the prescription doses( V100, V150, and V200), conformity index(CI), external index(EI), and homogeneity index(HI)of the target volume. Results:The median lesion volume was 29.20 cm 3, the median seed number was 54, and the median D90 was 150 Gy.The post-implant V150 was lower than pre-plan V150 (64.1% vs. 67.1%, t=2.937, P=0.011), and the post-implant mean HI was higher than pre-plan HI (32.01% vs. 26.68%, t=-2.950, P=0.011). There were no significant differences in other dosimetric parameters before and after seed implantation. Conclusions:With CT-guided radioactive seed implantation assisted by a navigation system and 3D-printing template in the treatment of recurrent malignant pelvic tumors, the actual postoperative dose could meet the preoperative plan requirement, ensuring the accuracy and consistency of the dose delivered.

【Objective】 To investigate the mechanisms of chelerythrine on the treatment of breast cancer based on network pharmacology and molecular docking. 【Methods】 The targets corresponding to chelerythrine and breast cancer were obtained from Mala Cards and Swiss Target Prediction databases. Chelerythrine-related and breast cancer-related targets were found and then combined to get an intersection, which represented potential anti-breast cancer targets of chelerythrine. A protein-protein interaction (PPI) network was constructed from the STRING database and key genes were screened using the topological analysis. Gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis of targets were conducted using metascape database. The relationship between the expressions of key target genes and the survival curve was analyzed using the Kaplan-Meier Plotter database. Molecular docking analysis was performed by AutoDock Vina to verify whether chelerythrine has a definite affinity with key targets. 【Results】 A total of 37 potential targets were obtained in chelerythrine against breast cancer. The result of the topology analysis included 8 key targets. The GO enrichment analysis included 317 GO items. The KEGG pathway analysis included 80 pathways, which were closely related to the PI3K/AKT signaling pathway, the ErbB signaling pathway, VEGF signaling pathway, and others. The results of the survival curve analysis showed that the expression levels of CHEK1, PIK3CA, mTOR and PTGS2 genes were related to the survival time of breast cancer patients. The results of molecular docking proved that the combined activity of chelerythrine with key targets was excellent. 【Conclusion】 Chelerythrine may play an anti-breast cancer role via the PI3K/AKT signaling pathway and has the potential to be developed into a clinical drug for breast cancer.

Objective: To compare the preoperative and postoperative dosimetric parameters in the treatment of spinal metastasis, and to verify the accuracy of 3D-printing non-coplanar template (3D-PNCT) combined with CT-guided ¹²⁵I seed implantation for the treatment of spinal metastasis. Methods: The treatment plans of 7 patients with spinal metastasis (9 lesions) from 2016 to 2018 receiving 3D-PNCT in combination with CT-guided ¹²⁵I seed implantation were retrospectively analyzed. The dosimetric parameters including homogeneity index (HI), conformal index (CI), external index (EI), dose of 90% target volume(D₉₀), mPD, volume percent of 100%, 150%, and 200% prescribed dose V₁₀₀、V₁₅₀、V₂₀₀ and D_2cm³ of spinal cord were compared before and after operation. The british columbia cancer ageny particle implantation quality evaluation standard was applied to evaluate the quality of implantation. Results: The HI, EI and CI, D₉₀, mPD, V₁₀₀, V₁₅₀, V₂₀₀ and D_2cm³ of spinal cord did not significantly differ before and after the plan (all P>0.05). Five were evaluated as excellent and 4 were assessed as good. Conclusion The postoperative dosimetric parameters of 3D-PNCT combined with CT guided ¹²⁵I seed implantation of spinal metastasis are basically consistent with preoperative dosimetric parameters. The postoperative plans are evaluated as excellent or good, suggesting that the technology has a good therapeutic accuracy in the treatment of spinal metastasis.

Objective:To compare the difference of preoperative and postoperative plans of navigation-assisted three-dimensional (3D)-printing template combined with CT-guided radioactive 125I seeds implantation for malignant tumors, and verify preliminarily the plan quality of optical navigation-assisted seeds implantation. Methods:From December 2018 to November 2019, a total of 20 patients (10 males, 10 females, median age: 60.5 years) with malignant tumors received navigation-assisted 3D-printing template combined with CT-guided radioactive 125I seeds implantation in Peking University Third Hospital. Eight cases were implanted in the head and neck, 1 case in the chest wall, 9 cases in the pelvis and 2 cases in the paravertebral and/or retroperitoneal region. The median prescription dose was 150 Gy. The data in the preoperative and postoperative plans was compared, including seeds number, needles number, and some dosimetry parameters. Dosimetry parameters including dose delivered to 90% gross tumor volume (GTV) ( D90), percentage of GTV received 100%, 150%, and 200% of the prescribed dose ( V100, V150, V200), minimum peripheral dose (MPD), conformal index (CI), external index (EI), homogeneity index (HI) of target volume, and 2 cm 3 range of spinal cord receiving dose ( D2 cm 3). Paired t test and Wilcoxon signed rank test were used to analyze the data. Results:The needles number of preoperative and postoperative plans was the same (both 12 (9, 19)), and the seeds number of postoperative plan was more than preoperative plan with no significant difference (51(35, 68) vs 49(35, 63); z=1.859, P>0.05). The MPD of postoperative plans was higher than preoperative plans ((80.52±14.89) vs (67.22±20.56) Gy, t=-3.769, P=0.001). There were no significant differences in other dosimetry parameters between the two plans ( t values: -0.533, -0.423, z values: from -0.849 to 1.416, all P>0.05). Postoperative dose quality assessment was excellent in 17 cases (17/20), good in 2 cases (2/20) and middle in 1 case (1/20). Conclusions:The quality of the implantation is good under the guidance of combined mode. The actual target dose after operation can meet the requirements of preoperative planning.

Objective: To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan. Methods: The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure. Results: Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05). Conclusions The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age.

Objective To evaluate the clinical efficacy and safety of CT-guided 125 I seed implantation in the treatment of recurrent head and neck tumors after radiotherapy. Methods Clinical data of 101 patients who received CT-guided radioactive 125 I seed implantation for recurrent head and neck cancer after radiotherapy from 2007 to 2015 were retrospectively analyzed. The median accumulated dose of external radiotherapy was 66 Gy and the median dose after seed implantation (D90) was 117 Gy. The local progression-free survival and overall survival were analyzed by Kaplan-Meier method. Univariate analysis was performed by log-rank test and multivariate analysis was conducted by using Cox regression model. Results The median follow-up time was 12. 2 months. The 5-year local progression-free survival rate was 26. 6％.The 5-year overall survival rate was 15. 5％. Univariate analysis demonstrated that age,pathological type,implantation site,lesion volume,D90 and short-term efficacy were correlated with local control,and KPS score,lesion volume ,D90,and short-term efficacy were associated with survival (all P<0. 05). Multivariate analysis revealed that pathological type,lesion volume ,D90 and short-term efficacy were independent factors related to local control (P= 0. 000, 0. 002,0. 003 and 0. 014).In terms of the adverse events,skin/ mucosal ulceration was observed in 25. 7％ and pain occurred in 13. 9％ of all patients. No correlation was noted between the adverse events and dose.Conclusions CT-guided radioactive 125 I seed implantation is an efficacious and safe treatment of recurrent head and neck tumors after radiotherapy. Non-squamous carcinoma,small lesion volume and high dose (D90) indicate excellent local control.

Objective To verify the accuracy of three-dimensional printing coplanar coordinate template (3D-PCCT) technology for 125I seeds implantations in chest tumor at dosimetry level.Methods From January 2016 to June 2017,a total of 22 patients (15 males,7 females;median age 62 years) with chest tumors who received 3D-PCCT assisted 125I seeds implantation in Peking University Third Hospital were enrolled in this retrospective study.There were 8 patients with primary lung cancer and 14 with metastatic carcinoma.The sites for implantation included lung (12 cases),mediastinum (2 cases) and chest wall (8 cases).The prescribed dose was 110-180 Gy.The preoperative plan design,puncture and seeds implantation guided by template were carried out and the dose distribution of postoperative plan was compared with that of preoperative plan.Dose parameters included dose delivered to 90％ gross tumor volume (D90),minimum peripheral dose,the percentage of GTV receiving 100％ prescription dose (V100),the percentage of GTV receiving 150％ prescription dose (V150),conformity index,external index of target volume,uniformity index,D2 cm3 of spinal cord and aorta,and V20 of affected side lung.Wilcoxon signed rank test was used to analyze the data.Results The median D90 was 150.4(125.6,187.0) Gy.Postoperative D90 was higher than the prescribed dose in 68％ (15/22) cases.For median value of most parameters,there were no significant differences between the postoperative plans and preoperative plans (all P＞0.05) except for the actual V100,which was lower than the preplanned (95.5％ vs 97.2％;P=O.040).Conclusion 3D-PCCT could provide good accuracy in 125I seeds implantation for chest tumor.